Business Analyst

by Irma Moore | Jan 16, 2025 | Uncategorized

The Business Analyst will play a critical role in supporting the Illinois Enterprise Data Warehouse (EDW) for the State of Illinois Medicaid program. This position requires a deep understanding of Medicaid systems, including claims processing, eligibility, and third-party liability, as well as expertise in analyzing complex healthcare data. The Business Analyst will work closely with stakeholders, technical teams, and business units to ensure the successful implementation and operation of the EDW. Responsibilities include providing data-driven insights, anticipating Medicaid agency needs, and developing innovative solutions to improve decision-making. 

**This is a remote position with occasional travel (<25%) to Springfield, IL, for onsite meetings and collaboration.**

 Duties:

• Provide guidance for Medicaid data warehouse implementation and operations.
• Offer Medicaid/CHIP expertise on claims processing, eligibility, and third-party liability.
• Anticipate state data needs and develop solutions to meet them.
• Collaborate with teams to analyze and utilize healthcare data effectively.
• Develop tools like dashboards, data visualizations, and reports.
• Support stakeholders with activity and value analytics.

Requirements

• 10+ years of healthcare data analysis experience.
• 4+ years working with/for State Medicaid agencies.
• 2+ years in CMS Federal Reporting, quality measures, claims processing, Medicaid eligibility, or provider enrollment.
• Strong understanding of claims adjudication and managed care processes.
• Excellent communication, teamwork, and mentoring skills.
• Ability to travel up to 25% to Springfield, IL.

Preferred Qualifications:

• Proficiency in SQL and data analysis tools (e.g., Teradata).
• Experience with JIRA, Rally, or DevOps.
• Prior involvement in large-scale implementation projects.

Physical Requirements & Environmental Conditions: 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this position, the employee is regularly required to sit and use hands to handle, or feel objects, a keyboard and other office equipment. The employee frequently is required to sit in meetings for long periods of time. The employee will utilize technology tools such as a laptop computer for extended periods of time. The employee must be able to reach with hands and arms and talk or hear. Specific vision abilities required by this position include close vision, color vision, and the ability to adjust focus. The noise level in the work environment is usually moderate.

Briljent is a solutions-based company. Solutions come from creative ideas; ideas come from being creative with differences. Briljent believes diversity and inclusion are critical to the success of the company. Employment at Briljent is based on merit and professional qualifications. We do not discriminate against any employee or applicant because of race, creed, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, veteran status, marital status or any other basis protected by federal, state or local law, regulation or ordinance.

Broker Agent Service Specialist – National Remote

by Irma Moore | Jan 16, 2025 | Uncategorized

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.  

In this role, you will play a key part in supporting Agent Lifecycle Management by analyzing and processing new and existing agent requests for UHC. This includes reviewing applications and contracts through to completion. You will provide exceptional customer service to all internal staff and external customers.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. 

Primary Responsibilities: 

• Review applications, gather data, determine eligibility and compliance
• Process broker and agent licensing, appointment, and contracting credentials for UHC Products
• Ensure that all paperwork, credentials, and other necessary documents are in good order
• Perform analysis of submitted material for completeness and accuracy, analyzing credentials and documentation
• Ensure cases adhere to all policies and procedures, in addition to federal and state laws and regulations
• Identify risks or issues and assess/implement alternate solutions
• Handle processing of licensing, appointing, and contracting work
• Monitor the day-to-day activity on assigned accounts to keep agents and other stakeholders informed of relevant information or lack thereof
• Participate in interdepartmental team efforts, such as the implementation of updates to the production system
• Input applications and process changes to current contracts
• Responsible for analyzing, processing, and completing cases
• Process approximately 20-30 cases per day
• Perform other related duties as required to achieve the goals and objectives of the company and department

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. 

Required Qualifications: 

• High School Diploma/GED (or higher)
• 2+ years of experience in a customer service or sales support role
• 1+ years of experience using multiple computer programs simultaneously to enter, review, and verify information
• Intermediate level of proficiency using MS Outlook for calendar management, meetings, emailing, and managing email folders
• Intermediate level of proficiency using Excel for data entry, sorting, filtering, and entering information into basic tables
• Intermediate level of proficiency using MS Word to create general correspondence, use spell and grammar check tools, and enter information into forms/templates

Preferred Qualifications: 

• Previous healthcare industry experience
• Knowledge of insurance industry compliance, licensing, or claims

Soft Skills:

• Excellent written and verbal communication skills required
• Strong communication and interpersonal skills; able to work with team members and all levels within the organization
• Strong analytical/problem-solving skills

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. 

The salary range for this role is $19.86 to $38.85 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.  

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. 

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. 

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

Business Process Analyst – Remote

by Irma Moore | Jan 16, 2025 | Uncategorized

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Think of this as a triple play. You have Fortune 6 global operations. You have a complex, matrix organization with dozens of interrelated business units. And you have a fast-paced, intense culture where everyone is pushing the envelope. Now, you can step into this challenge and help create new business process solutions that raise the performance of our health care system for years to come. As a Business Process Analyst, you’ll be in the driver’s seat on vital projects that have strategic importance to our mission. If you’re ready to play in the big leagues, it’s your move.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 

Primary Responsibilities:

• Create, control and improve end-to-end business processes
• Lead process design and project implementation teams in process improvement activities
• Create quality reporting, analysis and audits for developing plans and programs to support continuous quality improvement
• Assist in the creation, implementation and evaluation of Total Quality Management (TQM) programs

You won’t be any ordinary Business Process Analyst. You’ll be hitting on all cylinders every moment of every day.

You will create process design, implement projects, diagnose process improvement opportunities and develop solutions in the quest for better health care. You’ll be expected to quickly adapt to change in a very fluid environment and collaborate with multiple stakeholders to agree on solutions

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:        

• 2+ years of experience with business analysis and process improvement
• 1+ years of specific experience with documenting processes and practices, often in accepted project methodology artifacts
• 1+ years of experience with MS Project, Word, Excel, PowerPoint and Visio
• Ability to communicate and present complex information to executive leadership
• Ability to work standard work hours in CST time zone 
• United States Citizenship 

Preferred Qualifications:        

• 2+ years of experience Lean or Agile
• SQL or Tableau experience

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The hourly range for this role is $28.03 to $54.95 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. 

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.

Software Developer II

by Irma Moore | Jan 15, 2025 | Uncategorized

About Us

Lumicera – Lumicera Health Services Powered by Navitus – Innovative Specialty Pharmacy Solutions- Lumicera Health Services is defining the “new norm” in specialty pharmacy to optimize patient well-being through our core principles of transparency and stewardship. Here at Lumicera, our team members work in an environment that celebrates creativity and fosters diversity.

Pay Range

USD $77,545.00 – USD $95,148.00 /Yr.

Work Schedule Description (e.g. M-F 8am to 5pm)

M-F 8am to 5pm

Remote Work Notification

ATTENTION: We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.

Overview

Lumicera Health Services is seeking a Software Developer II to join our Lumicera IT department!

The Software Developer II ensures efforts are in alignment with the Lumicera IT department to support customer-focused objectives and the IT Vision, a collaborative partner delivering innovative ideas, solutions and services to simplify people’s lives. The Software Developer II’s role is to define, develop, test, analyze, and maintain existing applications in support of the achievement of business requirements. This includes writing, coding, testing, and analyzing software programs and applications. The Software Developer II will also research, design, document, and modify software specifications throughout the production life cycle. 

Is this you? Find out more below!  

Responsibilities

How do I make an impact on my team?

• Collaborate with analysts, programmers and designers in conceptualizing and development of software programs and applications 
• Analyze and assess existing business systems and procedures 
• Define, develop, and document software business requirements, objectives, deliverables, and specifications on a project-by-project basis in collaboration with internal users and departments 
• Design, develop, document, and implement new applications and application enhancements according to business and technical requirements 
• Assist in defining software development project plans, including scoping, scheduling, and implementation 
• Research, identify, analyze, and fulfill requirements of all internal and external program users. 
• Recommend, schedule, and perform software improvements and upgrades 
• Consistently write, translate, and code software programs and applications according to specifications 
• Write new and modify existing programming scripts to enhance functionality and/or performance of company applications as necessary 
• Liaise with network administrators, systems analysts, and software engineers to assist in resolving problems with software products or company software systems 
• Design, run and monitor software performance tests on new and existing programs for the purposes of correcting errors, isolating areas for improvement, and general debugging 
• Administer critical analysis of test results and deliver solutions to problem areas 
• Generate statistics and write reports for management and/or team members on the status of the programming process 
• Liaise with vendors for efficient implementation of new software products or systems and for resolution of any adaptation issues 
• Conduct research on emerging application development software products, languages, and standards in support of procurement and development efforts 
• Develop and maintain user manuals and guidelines 
• Train end users to operate new or modified programs 
• Install software products for end users as required 
• React, Material UI (MUI), C#, AWS, Mongo, Relational database 
• Working knowledge of source control tools such as ADO and GitHub 
• On-call availability and some travel may be required
• Other duties as assigned 

Qualifications

What our team expects from you?

• College diploma or university degree in the field of Computer Science, Information Systems, or Software Engineering, and/or 6 years equivalent experience 
• 2 years of experience required 
• Experience interviewing end-users for insight on functionality, interface, problems, and/or usability issues 
• Hands-on experience developing test cases and test plans 
• Experience with agile methodologies and Agile project management tools such as Jira, Azure DevOps, etc. 
• Experience with cloud-first, API-first and microservice architecture and or strategies is preferred. 
• Experience with Javascript required 
• Experience with CI/CD pipelines and DevOps practices is preferred 
• Healthcare industry practices and HIPAA knowledge is preferred  
• Participate in, adhere to, and support compliance program objectives 
• The ability to consistently interact cooperatively and respectfully with other employees 

What can you expect from Lumicera? 

• Top of the industry benefits for Health, Dental, and Vision insurance 
• 20 days paid time off 
• 4 weeks paid parental leave 
• 9 paid holidays 
• 401K company match of up to 5% – No vesting requirement 
• Adoption Assistance Program 
• Flexible Spending Account 
• Educational Assistance Plan and Professional Membership assistance 
• Referral Bonus Program – up to $750! 

We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming. 

#LI-Remote

Location : Address

Remote

Location : Country

US

Data Specialist

by Irma Moore | Jan 15, 2025 | Uncategorized

Career Area:Technology, Digital and Data

Job Description:

Your Work Shapes the World at Caterpillar Inc.

When you join Caterpillar, you’re joining a global team who cares not just about the work we do – but also about each other.  We are the makers, problem solvers, and future world builders who are creating stronger, more sustainable communities. We don’t just talk about progress and innovation here – we make it happen, with our customers, where we work and live. Together, we are building a better world, so we can all enjoy living in it.

Cat Digital is the digital and technology arm of Caterpillar Inc., responsible for bringing world-class digital capabilities to our products and services. With almost one million connected assets worldwide, we’re focused on using IoT and other data, technology, advanced analytics and AI capabilities to help our customers build a better world.

Job Summary:

This is position is in the Connected Data Quality team in Cat Digital. The team is responsible for processes to enable (E2E) telemetry data quality monitoring, finding sources of quality issues, and working with process partners to resolve the problems at source.

To identify and find solutions to telemetry data failures and, coordinate and communicate quality issues to CPI teams and process partners to drive improvements.

What You Will Do:

• Identify telemetry data quality issues by data mining and analysis.
• Requirements development for telemetry data business rules
• Work with internal teams to get buy-in on requirements, implementation, and testing.
• Lead validation of business rules, defect triage, and monitoring of telemetry data for production and field follow.
• Investigates hardware and software issues and provides technical information for the continuous product improvement (CPI) process.
• Assesses the impact of field product problems on the company and the customer.
• Ability to work with global teams/different time zones and backgrounds.

What You Will Have:

Value Realization: Knowledge of value realization methods; ability to plan, execute, monitor and manage business activities and resources to determine and achieve the actual value from a business initiative as estimated in an associated business case.
Communicating Complex Concepts: Knowledge of effective presentation tools and techniques to ensure clear understanding; ability to use summarization and simplification techniques to explain complex technical concepts in simple, clear language appropriate to the audience.
Agile Development: Knowledge of agile methodologies and the agile development lifecycle; ability to utilize formal agile methodologies, disciplines, practices and techniques for the delivery of new and enhanced applications.
Cloud Computing: Knowledge of the concepts, technologies and services of cloud computing; ability to design, deploy and implement cloud computing solutions in various business environment.
Database Design (Physical): Knowledge of database systems; ability to establish a data model for designing an organization’s database that runs effectively and efficiently for better business outcome.
ETL Process: Knowledge of the extraction, transformation and loading (ETL) process; ability to develop a database through the ETL process.
Information Management: Knowledge of an organization’s existing and planned Information Architecture and Information Management (IM) methodology; ability to collect and manage information from different sources, and distribute this information to enhance operational efficiency.
Modeling: Data, Process, Events, Objects: Knowledge of data, process and events; ability to use tools and techniques for analyzing and documenting logical relationships among data, processes or events.
 

Considerations For Top Candidates:

• This position typically requires an accredited engineering degree.
• 3-5 years of development or product support experience in IoT/ telemetry systems
• Must have demonstrated excellent troubleshooting skills and the ability to work effectively in a high-velocity environment.
• Requires the ability to effectively communicate technical information to a broad range of audiences.
• The incumbent must have strong initiative, interpersonal, organizational, and teamwork skills.
• Knowledge of Caterpillar telemetry devices and telemetry data.
• Previous knowledge of Caterpillar products, working with a different business unit, or working with different products, processes or systems is desirable.
• Knowledge of Tableau/BI tools, scripting to automate data analysis, and SQL query development.
• Experience with handling large data sets in various formats.

What You Will Get:

Working with a Fortune 100 leader, you can build your career on a global scale and take advantage of development opportunities with emerging technologies. We’ve created an inclusive environment for you to explore your passions, make an impact and do the work that really matters. Join Us.

Additional Information:

This position is open for remote work

Sponsorship is not available for this role

#LI

#BI

About Caterpillar

Caterpillar Inc. is the world’s leading manufacturer of construction and mining equipment, off-highway diesel and natural gas engines, industrial gas turbines and diesel-electric locomotives. For nearly 100 years, we’ve been helping customers build a better, more sustainable world and are committed and contributing to a reduced-carbon future. Our innovative products and services, backed by our global dealer network, provide exceptional value that helps customers succeed.

Summary Pay Range:$87,480.00 – $131,280.00

Compensation and benefits offered may vary depending on multiple individualized factors, job level, market location, job-related knowledge, skills, individual performance and experience. Please note that salary is only one component of total compensation at Caterpillar. 

Benefits:

Annual incentive bonus plan*

Medical, dental, and vision coverage

Paid time off plan (Vacation, Holiday, Volunteer, Etc.)

401k savings plan

Health savings account (HSA)

Flexible spending accounts (FSAs)

Disability benefits

Life Insurance

Parental leave

Healthy Lifestyle Programs

Employee Assistance Programs

Voluntary Benefits and Employee Discounts

Tuition Reimbursement

Career Development

*Subject to annual eligibility and incentive plan guidelines.Visa Sponsorship is not available for this position. This employer is not currently hiring foreign national applicants that require or will require sponsorship tied to a specific employer, such as, H, L, TN, F, J, E, O. As a global company, Caterpillar offers many job opportunities outside of the U.S which can be found through our employment website at www.caterpillar.com/careers.